Pharmacovigilance in Action: Antibiotic-Induced Stevens–Johnson Syndrome in Primary Care

Abstract

Introduction: Stevens-Johnson Syndrome (SJS) is an uncommon, severe mucocutaneous hypersensitivity reaction caused by medications, especially antibiotics. This report describes a case of SJS in a patient who received numerous antibiotics for lower limb cellulitis, emphasising the necessity of early detection, immediate drug withdrawal, and supportive care. Case Presentation: A 75-year-old male presented with chest pain, fever, vomiting, loose motions, and left leg pain to the Ekashilaa hospital, Hanamkonda, alongside a history of CAD and CVA. Examination revealed pedal edema, mild icterus, and a temperature of 101°F. Investigations indicated anaemia, elevated white blood cell count, prolonged prothrombin time, and mild proteinuria. Ultrasound showed minimal perinephric fluid and pleural effusion. Initially treated for cellulitis with clindamycin, piperacillin/tazobactam, and levofloxacin, the patient developed bullae lesions and was switched to cephalosporins. Management included intravenous hydrocortisone, dexamethasone, Pheniramine maleate, and local treatments. The patient was discharged in a stable condition. Conclusion: This case demonstrates the Stevens-Johnson Syndrome can be brought on by antibiotics. It's critical to give sufficient supportive care, detect the illness early, and quickly stop the suspected drugs in order to lower morbidity and mortality.